First Online: 22 July 2017Received: 08 February 2017Accepted: 11 July 2017

Abstract

PurposePreexisting diabetes is associated with increased morbidity and mortality in cancer. We examined the impact of incident cancer on the long-term outcomes of diabetes.

MethodsUsing the United Kingdom Clinical Practice Research Datalink, we identified three cohorts of diabetes patients subsequently diagnosed with breast, colorectal, or prostate cancer, each matched to diabetic noncancer controls. Patients were required to have survived at least 1 year after cancer diagnosis cases or a matched index date controls, and were followed up to 10 years for incident microvascular and macrovascular complications and mortality. Multivariate competing risks regression analyses were used to compare outcomes between cancer patients and controls.

ResultsOverall, there were 3382 cancer patients and 11,135 controls with 59,431 person-years of follow-up. In adjusted analyses, there were no statistically significant p ≤ 0.05 differences in diabetes complication rates between cancer patients and their controls in any of the three cancer cohorts. Combined, cancer patients were less likely adjusted hazard ratio HR 0.88; 95% CI = 0.79–0.98 to develop retinopathy. Cancer patients were more likely to die of any cause including cancer, but prostate cancer patients were less likely to die of causes associated with diabetes HR 0.61; 95% CI = 0.43–0.88.

Conclusions and implicationsThere is no evidence that incident cancer had an adverse impact on the long-term outcomes of preexisting diabetes.

Implications for Cancer SurvivorsThese findings are important for cancer survivors with preexisting diabetes because they suggest that substantial improvements in the relative survival of several of the most common types of cancer are not undermined by excess diabetes morbidity and mortality.